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General NPI Number Information
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NPI Number | 1871685461
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Entity Type | Organization
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Legal Business Name | LUDAG LLC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 600 GRANT ST
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City | GARY
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State | IN
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Zip | 46402-6001
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Country | US
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Telephone | 219-739-5598
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 85327
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City | CHICAGO
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State | IL
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Zip | 60689-5327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT T WOODBURN III
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Credential | MD
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Telephone | 219-739-5598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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